Individual
MS. SHIRLEY A FONTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4001 N CLASSEN BLVD, OKLAHOMA CITY, OK 73118-2685
(405) 524-2424
Mailing address
3739 NW 14TH ST, OKLAHOMA CITY, OK 73107-4307
(405) 361-1966
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M000028230
—
OK
Enumeration date
06/21/2019
Last updated
06/21/2019
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